Challenges in accessing reproductive health care in young cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 107-107
Author(s):  
Bridgette Thom ◽  
Catherine Benedict ◽  
Danielle Novetsky Friedman ◽  
Debbie Diotallevi ◽  
Nirupa Jaya Raghunathan ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Reproductive Health ◽  
Cancer Survivors ◽  
Fertility Preservation ◽  
Cost Of Care ◽  
Care Providers ◽  
Reproductive Health Care ◽  
Female Survivors ◽  
The Impact

107 Background: Infertility and early menopause are well-established late and long-term effects of many cancer treatments. Fertility preservation (FP) before (and in some cases after) treatment allows many survivors to achieve their family building goals despite gonadotoxic treatment. FP, however, is costly, and there is inconsistent, incomplete, or absent coverage across insurances. Furthermore, as many young survivors are un- or underinsured, disparities in referrals and service utilization have emerged. This presentation provides an overview of reproductive health care-related financial issues affecting young adult survivors, including cost of care, access to services, and relevant advocacy efforts, and highlights an analysis of the impact of income on FP decisions in a national sample of female survivors. Methods: We recruited female survivors aged 18-35 via social media and collected data using a web-based survey. Analyses included bivariate statistics and multiple logistic regression. Outcomes were receiving a fertility intervention (undergoing evaluation and/or fertility preservation of any sort) and freezing eggs/embryos before or after treatment. Results: 346 survivors, who were an average of 4.9 years (sd = 5.4) post-treatment, participated. 296 (86%) reported income: 35% <$50K; 39% $50K-100K; and 26% over 100K. Of 259 respondents who did not undergo FP, 27% reported cost as a barrier. In logistic regression, income was significantly related with receiving an intervention and freezing eggs/embryos. Controlling for age and nulliparity, high-income survivors were more likely to receive a fertility intervention (OR = 3.0, 95% CI: 1.3, 6.9) and to freeze eggs/embryos (OR = 3.4, 95% CI: 1.2, 9.5) than low-income survivors. Conclusions: Our findings of disparity in utilization of reproductive health care among cancer survivors were similar to the published literature, with income impacting respondents’ receipt of fertility intervention and freezing of eggs/embryos. Clinical interventions and policy initiatives must address this service gap. Health care providers can help ensure that cancer survivors have access to available financial resources to assist with cost to facilitate their reproductive health care.

scholarly journals The Impact of COVID-19 Infection on Maternal and Reproductive Care Services in Governmental Health Institutions of Dessie town, North-East Ethiopia, 2020 G.C.

2021 ◽  
Author(s):  
Kibir Temesgen Assefa ◽  
Amare Workie Gashu ◽  
Tenagnework Dilnessa Mullualem ◽  
Ermias Getaneh Ayele
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Care ◽  
Care Services ◽  
North East ◽  
Health Institutions ◽  
The Impact

Abstract Background: The COVID 19 pandemic is causing huge stress on the health care system of all countries in the world. The impact of the pandemic is both social and economic. Pregnancy is an exciting and sometimes stressful experience. Being pregnant during a disease outbreak may add extra anxiety and concern for pregnant women and for those who provide care for them [1, 2]. During the initial stages of the pandemic, it appeared Africa would be spared the burden of COVID-19. However, by April 7th, a total of 45 countries within the WHO African region had reported over 7000 cases (although some place it at over 10 000), with at least 292 deaths and 612 people recovered. Ethiopia, being one of the developing countries trying to address the diverse needs of its people, is currently at the verge of the epidemic [5, 7]. Objectives: The general objective of this study was to assess the impact of COVID-19 infection on maternal and reproductive health care services among mothers getting service in governmental health institutions of Dessie town, 2020 G.C. Methods: Institution based cross sectional study design using mixed (quantitative supplemented with qualitative) method was employed to identify the impact of COVID-19 infection on maternal and reproductive health care services among women who get service in governmental health institutions of Dessie town. The study was conducted from July 1-15 / 2020. Result: According to this study, Six percent (6%) of antenatal care attendees, 18% of delivery care attendees and nearly half (46.7%) of postnatal care attendees reported inappropriate service delivery due to fear of health care providers, shortage medical supplies and staff work load. The study also showed that utilization of these services was decreased due to fear of clients to go to health institutions. Conclusion and recommendation : This study concluded that COVID-19 significantly affects the quality and utilization of maternal and reproductive health care services. The study also showed that utilization of these services was decreased due to fear of clients to go to health institutions. Ministry of health should continue maternity and reproductive health care services such as family planning to be prioritized as an essential core health service.

scholarly journals The impact of COVID-19 infection on maternal and reproductive health care services in governmental health institutions of Dessie town, North-East Ethiopia, 2020 G.C.

2020 ◽  
Author(s):  
Kibir Temesgen Assefa ◽  
Amare Workie Gashu ◽  
Tenagnework Dilnessa Mulualem
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Care ◽  
Care Services ◽  
Health Institutions ◽  
The Impact

Background: The COVID 19 pandemic is causing huge stress on the health care system of all countries in the world. The impact of the pandemic is both social and economic. Pregnancy is an exciting and sometimes stressful experience. Being pregnant during a disease outbreak may add extra anxiety and concern for pregnant women and for those who provide care for them [1, 2]. During the initial stages of the pandemic, it appeared Africa would be spared the burden of COVID-19. However, by April 7th, a total of 45 countries within the WHO African region had reported over 7000 cases (although some place it at over 10 000), with at least 292 deaths and 612 people recovered. Ethiopia, being one of the developing countries trying to address the diverse needs of its people, is currently at the verge of the epidemic [5, 7]. Objectives: The general objective of this study was to assess the impact of COVID-19 infection on maternal and reproductive health care services among mothers getting service in governmental health institutions of Dessie town, 2020 G.C. Methods: Institution based cross sectional study design using mixed (quantitative supplemented with qualitative) method was employed to identify the impact of COVID-19 infection on maternal and reproductive health care services among women who get service in governmental health institutions of Dessie town. The study was conducted from July 1-15 / 2020. Result: According to this study, Six percent (6%) of antenatal care attendees, 18% of delivery care attendees and nearly half (46.7%) of postnatal care attendees reported inappropriate service delivery due to fear of health care providers, shortage medical supplies and staff work load. The study also showed that utilization of these services was decreased due to fear of clients to go to health institutions. Conclusion and recommendation: This study concluded that COVID-19 significantly affects the quality and utilization of maternal and reproductive health care services. The study also showed that utilization of these services was decreased due to fear of clients to go to health institutions. Ministry of health should continue maternity and reproductive health care services such as family planning to be prioritized as an essential core health service. Key words: COVID-19, impact, antenatal care, Dessie

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Conscientious Objection to Sexual and Reproductive Health Services: International Human Rights Standards and European Law and Practice

2012 ◽  
Vol 19 (3) ◽  
pp. 231-256 ◽  
Author(s):  
Christina Zampas ◽  
Ximena Andión-Ibañez
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Health Care Services ◽  
Conscientious Objection ◽  
Care Providers ◽  
Reproductive Health Care ◽  
Care Services ◽  
European Court

Abstract The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual’s right to reproductive health care.

A Reproductive Health Care program for Surrogate Mothers: A Mixed Methods study

2020 ◽  
Author(s):  
Marjan Goli ◽  
Shahnaz Kohan ◽  
Seiied Mahdi Ahmadi Oloonabadi ◽  
Ziba Farajzadegan ◽  
Zeinab Heidari
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Reproductive Health ◽  
Care Program ◽  
Psychological Support ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Surrogate Mothers ◽  
Reproductive Health Care ◽  
Health Care Program

Abstract Background: Surrogacy has become an alternative family formation option for women who are unable to carry a pregnancy. There is no comprehensive care program despite the different nature of this pregnancy. The present study aimed to develop a reproductive health care program for surrogate mothers within the cultural and social context of Iran.Methods: In the present sequential exploratory mixed methods study, first through a qualitative approach surrogate mothers, care providers, and policy makers of reproductive health services were selected purposefully. Data were collected by using the in-depth semi-structured interviews and analyzed. A care program draft was designed by integrating results of the qualitative study and reviewing the literature and guidelines, then appropriateness of each proposed care was assessed by a two- rounds Delphi technique (RAM) and the final reproductive health care program for surrogate mothers was developed.Results: The surrogate mothers' reproductive health needs were summarized in four main categories: surrogate mothers' extra care, educational training, psychological support, and protecting against surrogacy`s social and familial consequences. The reproductive health care program for surrogate mothers were developed in four sections: pre-pregnancy health screenings and legal counseling; special care during embryo transfer until pregnancy confirmation; psychological support and prenatal care of surrogacy until delivery and follow-up postpartum care.Discussion: Women face many challenges in surrogacy and need special cares such as legal counseling, reproductive health care, and psychological support. Implementation of this care program seems to help improve the reproductive health of these mothers.

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